Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
Key result
Transcatheter aortic valve replacement in patients with severe aortic stenosis was associated with an 8-year cumulative incidence of bioprosthetic valve failure of 4.51% (95% CI, 1.95-8.76%).
Population
288 consecutive patients with symptomatic severe aortic stenosis who reached at least 5-year follow-up after…
Design
Cohort
Follow-up
8 years
Authors
Discussion
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Member takes
Implication
Adds sparse 8-year TAVR durability data; leaves open questions on contemporary valve performance and need for larger studies.
Key Points
- To assess the 8-year incidence of structural valve dysfunction and bioprosthetic valve failure in patients undergoing transcatheter aortic valve replacement.
- Analyzed 288 consecutive patients (mean age 80.7±5.3 years; mean STS mortality score 8.1±5.1%) undergoing transcatheter aortic valve replacement between June 2007 and March 2012 with at least 5 years of follow-up.
- Defined structural valve dysfunction and bioprosthetic valve failure according to standardized EAPCI/ESC/EACTS criteria and analyzed outcomes using cumulative incidence functions to account for the competing risk of death.
- Eight-year overall survival was 29.8%, and mean transaortic gradients decreased significantly from 53.3±15.9 mm Hg pre-procedure to 10.5±4.5 mm Hg in-hospital post-procedure (P<0.001).
- Bioprosthetic valve failure occurred in 11 patients, corresponding to an 8-year cumulative incidence of 4.51% (95% CI, 1.95%–8.76%).
- Severe and moderate structural valve dysfunction occurred in 7 patients (8-year cumulative incidence: 2.39%; 95% CI, 0.77%–5.71%) and 13 patients (8-year cumulative incidence: 5.87%; 95% CI, 3.06%–9.96%), respectively, with redo procedures needed in 2 patients (0.7%).
Study Design
Type
Cohort (n=288)
Structured PICO
P
Population
288 older adults (mean age 80.7 years) with symptomatic severe aortic stenosis undergoing TAVR, followed for up to 8 years.
E
Exposure
Transcatheter aortic valve replacement (TAVR) with first-generation bioprostheses
O
Outcome
Incidence of long-term (8-year) structural valve dysfunction and bioprosthetic valve failurehard clinical
In an elderly, high-risk population, TAVR with first-generation bioprostheses demonstrated low rates of structural valve dysfunction and bioprosthetic valve failure at 8 years.
Cite This Study
Barbanti et al. (2018) conducted a cohort in symptomatic severe aortic stenosis (n=288). Transcatheter Aortic Valve Replacement (TAVR) was evaluated on bioprosthetic valve failure (95% CI 1.95-8.76). Transcatheter aortic valve replacement in patients with severe aortic stenosis was associated with an 8-year cumulative incidence of bioprosthetic valve failure of 4.51% (95% CI, 1.95-8.76%).